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Healthcare Reform: Looking At 2015

Friday, March 6th, 2015
Healthcare reform has been one of the top news stories and realities of life for the past few years. The reforms of 2014 were significant and those changes will still be felt well in 2015 and beyond. We will take a look at what the healthcare reform has in store next. For sure, we know there will be an increase in the Individual Mandate Penalty for those who still do not have coverage in 2015.

What Does Healthcare Reform Have In Store For 2015?

The Employer Mandate is the most significant change in healthcare for this year. This provision requires many large employers to offer health coverage for at least 70 percent of full-time employees and their dependents.

The employers covered by this mandate are those that employ at least 100 full-time workers (or “full-time equivalents”) in 2014. Coverage mandates will increase in 2016 to 95 percent coverage of full-time employees with a minimum employee count of 50 instead of 100.

For purposes of the healthcare law, a “full-time” employee is someone who works at least 30 hours per week or 130 hours per month. If an employer chooses not to offer health coverage at the mandated levels, the company will face a “non-offering employer” penalty. This penalty can add up to $2,000 for each employee (minus the first 30 employees at a company).

The Employer Mandate also requires employers to offer healthcare coverage that meets “minimum essential coverage” requirements, which means the coverage must offer “Affordability” and “Minimum Value” rules. To be affordable, the lowest level of health coverage offered by the employer cannot be more than 9.5 percent of an employee’s household income. To meet minimum value requirements, the coverage must pay at least 60 percent of the total cost of allowed benefits.

This mandate was originally supposed to go into effect in 2014. In mid-2013, the Obama administration announced they were postponing the mandate until 2015.

Increase In The Individual Mandate Penalty

Individuals who do not get healthcare coverage may have to pay a penalty for not meeting the required mandate. For those that do not have insurance in 2014, the penalties will either be 1 percent of the yearly household income, or $95 per person ($47.50 per child).

The penalties will increase for those that do not have healthcare coverage in 2015. The first penalty amount is 2 percent of the yearly household income. The maximum for this is the amount of the national average premium for a bronze plan. The second penalty amount is $325 per person ($162.50 per child). The maximum for this amount is $975 per household.

While the healthcare reforms for 2015 focus on employers and patients, the effects of the earlier changes are still being felt. If your company needs guidance on how the changes affect your business, contact an attorney at Brown & Fortunato You can reach our Healthcare Group by calling (806) 345-6320. Send us an email on our Contact Us page or you can also stop by our office to set up an appointment. We are located at 905 S. Fillmore, Suite 400 in Amarillo, Texas.

This information is subject to change. Please check for updates that are more recent than the published date of this article.